This Tuesday, October 1st, the call-in discussion group will be discussing Chapter 7 (Placebo Yo-Yos and Nocebo No-Nos) in Steve Ozanich's book The Great Pain Deception starting at 9 pm Eastern Time. It lasts an hour, sometimes a little longer. Phone lines will open half an hour early so you can talk to hosts and early callers. Here's how to join the discussion (for detailed instructions, visit http://go.tmswiki.org/connect ):

Before summarizing Steve Ozanich’s chapter 7, a few words from Walt Oleksy, not a doctor but a researcher and believer in TMS:

What is a placebo? The word comes from the Latin word placeo meaning “I please,” and is a simulated or otherwise medically ineffectual treatment for a disease or other medical condition intended to deceive the recipient. Sometimes patients given a placebo (also called “sugar pills”) treatment will have a perceived or actual improvement in a medical condition, a phenomenon commonly called “the placebo effect.”

The placebo effect can be produced by inert tablets, by sham surgery, and by false information. In medical research, placebos are given as control treatments and depend on the use of measured perception. Placebos can have a surprisingly positive effect on a patient who knows that the given treatment is without any drug, as compared with a control group who knowingly did not get a placebo.

In one common placebo procedure, a patient is given an inert pill, told that it may improve their condition, but not told that it is in fact inert. This may cause the patient to believe the treatment will change their condition, and this belief may produce a subjective perception of a therapeutic effect, causing the patient to feel their condition has improved – or an actual improvement in their condition.

The placebo effect points to the importance of perception and the brain’s role in physical health. However, the use of placebos as treatment in clinical medicine, as opposed to laboratory research, is ethically problematic as it introduces deception and dishonesty into the doctor-patient relationship. The United Kingdom Parliamentary Committee on Science and Technology states that “prescribing placebos usually relies on some degree of patient deception” and “prescribing pure placebos is bad medicine. Their effect is unreliable and unpredictable and cannot form the sole basis of any treatment.”

Now Walt’s summary of Steve Ozanich’s chapter 7:

Steve says, early in his chapter: “I firmly believe that ultimately every healing is mediated by the so-called placebo effect: that is, our deepest beliefs can heal or harm, even alter the expression of our DNA, as Dr. Bruce Lipton implies in the opening page of this book.”

(That opening, in the book The New Biology – Where Mind and Matter Meet by Dr. Lipton, PhD, reads: “Some of our current beliefs in our truths about medicine are actually not very correct at all – there’s a revolution going on in the healthcare area, but it’s at the leading edge of research… it really should come down to the people… We’ve really been messed up by some ideas that are not absolutely correct… nature is simple in how she does everything – once I explain this, then you really start to see how powerful you have been, but how limited you have because of alterations in our belief about how wonderful we’ve been. You’re not controlled by genes – you’re actually controlled by perceptions of the environment – perceptions being beliefs.”)

Ozanich also quotes Dr. Andrew Weill, from The Healer Archetype: “I am well aware that belief is a powerful influence on the outcome of treatment… the true source of healing is inside us – not outside.”

Ozanich write in chapter 7: “TMS healing doesn’t come from blind belief – it’s quite the opposite. It comes from a deeper understanding of what’s happening within because the truth is the fastest path to freedom. There is no ritual with TMS healing, or magic, or honestly intentioned deceit – only a new awareness.

“Credence that TMS healing is not a placebo comes from the fact that pain oftentimes leaves when knowledge is gained. This would be much more difficult if there was a real injury.

“Dr. Sarno points out that the fact that so many thousands of people heal through reading his books is proof that the TMS process is not a placebo. There’s no physical interjection or personal interaction of any kind in the healing process. So it’s not only the mere belief that heals people from chronic pain, it’s also an understanding of the process. When the physician explains to the sufferer exactly what is occurring, he is in essence taking away any placebo effect. I believe Dr. Sarno would agree that this was one of his most amazing findings regarding TMS – in explaining how the pain process works, his patients began to heal.

“With the placebo it’s the belief in the drug – or act – that ratifies the body’s constitution to free itself. The belief rallies the will to change, which in turn transforms the body.”

Steve says that when a doctor erroneously tells a patient they have a bad back or shoulder or knee, suffering naturally increases due to the “nocebo effect,” and the doctor has delayed the patient’s healing indefinitely with faulty medical advice, and harmed the patient.

He then goes on to write about surgery and other types of placebos including chiropractic manipulation which he calls “the therapeutic sugar pill.” He says a person may feel better at the end of lengthy visits of spinal adjustments but he is healing with or without the treatments, because he believes the adjustments heal him with hands-on healing touch.

But he says there is nothing wrong with having a chiropractic spine adjustment, provided you understand that pain does not come from structural misalignment or degeneration. Then it can be considered a muscular-skeletal massage that temporarily relieves some tension. But he also cautions that spinal manipulation can and often does perpetuate the pain by strengthening the person’s concept of misalignment, in the depths of the unconscious mind, much like physical therapy, which he considers another placebo.Steve asks, “Is TMS healing a placebo effect?” He answers it saying “Yes, if the definition of a placebo is predicated solely on your belief, the central mechanism of all healing.

“I do, though, differentiate between TMS healing (finding the truth about yourself) [meaning that one or more repressed emotions cause our pain] and healing by being ‘fooled’ through surgery, drugs, chiropractic, acupuncture, etc.,” all of which may ease the pain temporarily but not permanently.

Steve concludes saying that if your back hurts, it should heal within a reasonable time frame. “If after a few months there is no healing, begin looking at an emotional and conditional process behind the continuing pain.”

Steve cites a “20/2o0” television episode, “Dr. Sarno’s Cure,” when an attorney had seven herniated discs and was in severe pain, but it left him weeks after experiencing Dr. Sarno’s exam and lecture about TMS healing.

I hope you will join the call-in Tuesday night and share your thoughts on placebos and TMS healing, especially those who retain some degree of doubt that their pain is psychologically-caused and not structurally.

It is interesting, Walt, that the mere act of going into a doctor for treatment, let's say of a cold or flu virus, seems to have an immediate positive effect on the patient's perception of his symptoms (i.e. whether he's feeling better or not). Before you walk into the examination room to see the doctor, you're coughing, your throat is sore, your nose is running, and you feel anxious and/or depressed. After a couple of words from the doctor and an examination of your nose, throat and lungs, when you walk out of the doctor's office you invariably feel better (i.e. less symptomatic with a more positive cheery attitude). That's an example of an immediate placebo effect that occurs before you even start taking the medicine the doctor prescribes. Sounds as though just seeing the doctor and having some kind of hands on examination starts to mobilize your autoimmune system, which, in turn, results in a more positive mental attitude on your part. I know there's a guy at Harvard right now who is studying the placebo effect in an effort to figure out exactly what is going on in terms of biochemistry and neurochemistry. Anyone out there with a link to that story? Very interesting if the placebo phenomenon could be quantified and analyzed in a way acceptable to orthodox science and medicine. Perhaps, Steve O. knows the name of the researcher at Harvard and the gist of the methodology he's employing to study placebos and, by implication, nocebos?

Yes, Bruce, it does make one wonder why we feel we are healing if we go to a doctor.
Maybe it's the trust we put in them to heal us. But my doctor knows nothing about TMS
and just prescribes pills for everything. He should know about TMS and also about
natural ways of healing physically and emotionally. I've had to learn those methods on my own,
a lot of them I've learned from the TMSWiki forums and members.

A niece sent me this peaceful video clip this morning so I'll share it here.

There's the way you start feeling better when you decide to get out of bed and go to the doctor. Then, there's the way you start feeling better when you take the prescribed medication, only it occurs when you take the first pill, long before the active ingredient could have entered your blood stream. Very interesting field and your Chapt. 7 is choke full of hints and innuendos about the subtleties of the placebo response.

Just a reminder that the discussion group is tonight! Like always the lines will open up 30 minutes or so beforehand, but remember, the official discussion will begin at 9pm (ET), so please, hold your comments about the book until then so those who cannot attend the discussion live (such as myself, unfortunately) can have access to all of your wonderful insights via the recording of the discussion! Feel free to log into the text chatroom at www.tmswiki.org/chat as well. Have fun guys!

Thanks Walt for all your doing for the discussion group, your awesome
Thanks Becca for keeping all of us on time and up- dated
Thanks Bruce for being on time and always having the best summarys
This is a team that cant be beat, were on a roll guys
We had I think 8 call in last week and 7 different speakers
Id love to beat that mark tonight- it seems like the more insight
The closer we get to the Holy Grail, every time we talk in the discussion group
Were telling all the steps to heal, do you hear it,
tune in tonight and find out all you want to know about tmshealing
We want to get to the bottom of this placebo and nocebo debate
We need answers.

Happy October, everyone! Here's the audio from the first discussion group of the month. As always, you can listen to it using the audio player below, or you can download it as an mp3 by right-clicking on this link (or the link below the player) and choosing to save it to your computer as an mp3. Happy listening